Pacing management during cardiopulmonary resuscitation

Abstract

Systems and methods provide for coordinated cardiac pacing with delivery of cardiopulmonary resuscitation (CPR) to a patient. Managing cardiac pacing in a patient during a cardiac arrhythmia involves detecting a cardiac arrhythmia using a patient implantable medical device, prompting a cardiopulmonary resuscitation compression, and delivering, using the patient implantable medical device, a pacing pulse to a heart chamber in coordination with the compression prompt.

What is claimed is: 
     
       1. A method implemented using an implantable cardioverter-defibrillator (ICD), comprising:
 detecting a cardiac tachyarrhythmia of a patient using the ICD; 
 delivering a defibrillation therapy to treat the tachyarrhythmia using the ICD; 
 if the defibrillation therapy fails to terminate the tachyarrhythmia, temporarily disabling the ICD from delivering defibrillation therapy at least for a time during which cardiopulmonary resuscitation (CPR) is administered to the patient; 
 detecting CPR compressions using the ICD; and 
 enabling the ICD to deliver defibrillation therapy in response to termination of CPR. 
 
     
     
       2. The method of  claim 1 , further comprising temporarily disabling the ICD from delivering defibrillation therapy in response to the detecting the CPR compressions. 
     
     
       3. The method of  claim 1 , wherein if the defibrillation therapy fails to terminate the cardiac arrhythmia, and in response to the ICD detecting CPR compressions, temporarily disabling the ICD from delivering defibrillation therapy. 
     
     
       4. A method implemented using an implantable cardioverter-defibrillator (ICD), comprising:
 detecting a cardiac tachyarrhythmia of a patient using the ICD; 
 delivering a defibrillation therapy to treat the tachyarrhythmia using the ICD; 
 if the defibrillation therapy fails to terminate the tachyarrhythmia, temporarily disabling the ICD from delivering defibrillation therapy at least for a time during which cardiopulmonary resuscitation (CPR) is administered to the patient; 
 delivering, using the ICD, pacing pulses to the patient's heart at least during a time when defibrillation therapy is temporarily disabled; and 
 enabling the ICD to deliver defibrillation therapy in response to termination of CPR. 
 
     
     
       5. The method of  claim 1 , further comprising delivering, using the ICD, pacing pulses to the patient's heart in timed relation to the detected CPR compressions at least during a time when defibrillation therapy is temporarily disabled. 
     
     
       6. The method of  claim 1 , wherein enabling the ICD comprises enabling the ICD to deliver defibrillation therapy in response to the ICD detecting termination of CPR compressions. 
     
     
       7. A method implemented using an implantable cardioverter-defibrillator (ICD), comprising:
 detecting a cardiac tachyarrhythmia of a patient using the ICD; 
 delivering a defibrillation therapy to treat the tachyarrhythmia using the ICD; 
 if the defibrillation therapy fails to terminate the tachyarrhythmia, temporarily disabling the ICD from delivering defibrillation therapy at least for a time during which cardiopulmonary resuscitation (CPR) is administered to the patient; 
 generating audible prompts for prompting for a series of CPR compressions; and 
 enabling the ICD to deliver defibrillation therapy in response to termination of CPR. 
 
     
     
       8. The method of  claim 7 , comprising:
 delivering, using the ICD, pacing pulses to a heart chamber in coordination with the compression prompting. 
 
     
     
       9. A method implemented using an implantable cardioverter-defibrillator (ICD), comprising:
 detecting a cardiac tachyarrhythmia of a patient using the ICD; 
 delivering a defibrillation therapy to treat the tachyarrhythmia using the ICD, wherein delivering the defibrillation therapy comprises; 
 if the defibrillation therapy fails to terminate the tachyarrhythmia, temporarily disabling the ICD from delivering defibrillation therapy at least for a time during which cardiopulmonary resuscitation (CPR) is administered to the patient; 
 detecting the patient's transthoracic impedance using the ICD; 
 delivering, using the ICD, pacing pulses in coordination with changes in the detected transthoracic impedance; and 
 enabling the ICD to deliver defibrillation therapy in response to termination of CPR. 
 
     
     
       10. A medical device, comprising:
 an implantable cardioverter-defibrillator (ICD) comprising a compression detector configured to detect cardiopulmonary resuscitation (CPR) compressions; and 
 a controller of the ICD configured to detect a cardiac tachyarrhythmia of a patient and deliver defibrillation therapy to treat the tachyarrhythmia, the controller, in response to the defibrillation therapy failing to terminate the tachyarrhythmia, configured to temporarily disable the ICD from delivering defibrillation therapy at least for a time during which CPR is administered to the patient in response to the compression detector detecting CPR compressions, the controller configured to enable the ICD to deliver defibrillation therapy in response to termination of CPR. 
 
     
     
       11. The device of  claim 10 , wherein the controller is configured to temporarily disable the ICD from delivering defibrillation therapy in response to the compression detector detecting the CPR compressions. 
     
     
       12. The device of  claim 10 , wherein the controller is configured to temporarily disable the ICD from delivering defibrillation therapy in response to the defibrillation therapy failing to terminate the tachyarrhythmia and the compression detector detecting the CPR compressions. 
     
     
       13. The device of  claim 10 , wherein the ICD comprises a pacemaker, the controller configured to coordinate delivery of pacing pulses to the patient's heart by the pacemaker at least during a time when defibrillation therapy is temporarily disabled. 
     
     
       14. The device of  claim 10 , wherein the ICD comprises a pacemaker, the controller configured to coordinate delivery of pacing pulses to the patient's heart by the pacemaker in timed relation to the detected CPR compressions at least during a time when defibrillation therapy is temporarily disabled. 
     
     
       15. The device of  claim 10 , wherein the controller is configured to enable the ICD to deliver defibrillation therapy in response to the compression detector detecting termination of CPR compressions. 
     
     
       16. The device of  claim 10 , wherein the ICD comprises an audio signal generator, and the controller is configured to cooperate with the audio signal generator to generate audible prompts for prompting for a series of CPR compressions. 
     
     
       17. The device of  claim 10 , wherein the ICD comprises an audio signal generator and a pacemaker, the controller configured to cooperate with the audio signal generator and the pacemaker to generate audible prompts for prompting for a series of CPR compressions and deliver a pacing pulse to a heart chamber in coordination with the compression prompting. 
     
     
       18. The device of  claim 10 , wherein the compression detector comprises a transthoracic impedance sensor and the ICD comprises a pacemaker, the controller configured to control delivery of pacing pulses in coordination with changes in a sensed transthoracic impedance signal produced by the impedance sensor indicative of CPR compressions. 
     
     
       19. The device of  claim 10 , wherein the compression detector comprises an accelerometer and the ICD comprises a pacemaker, the controller configured to control delivery of pacing pulses in coordination with changes in an accelerometer output signal produced by the accelerometer indicative of CPR compressions. 
     
     
       20. The device of  claim 10 , wherein the controller is configured to store data pertaining to coordination between electrical cardiac stimulation and CPR compression, and transfer the stored data to an external device.